踏车运动训练对慢性阻塞性肺病患者吸气肌力、呼吸困难和下肢疲劳程度的影响  

The effects of treadmill training on inspiratory muscle strength, dyspnea and lower limb fatigue in chronic obstructive pulmonary disease patients

作　　者：陈瑞[1] 陈荣昌 毛晓群[1] 陈新[3] 

机构地区：[1]中山大学附属二院呼吸内科,广州510120 [2]广州医学院呼吸疾病国家重点实验室 [3]南方医科大学珠江医院呼吸内科

出　　处：《中华物理医学与康复杂志》2011年第3期207-210,共4页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：广东省科技计划社会发展项目（E002009062）

摘　　要：目的探讨踏车运动训练后慢性阻塞性肺病（COPD）患者运动耐力的改善与吸气肌力、呼吸困难和下肢疲劳程度的关系。方法22例中、重度COPD患者分为康复组12例和对照组10例，康复组患者进行12周的下肢踏车运动训练。在运动训练前、后2组患者分别进行常规肺通气功能、弥散功能、肺容积、最大吸气压（MIP）、呼气气流受限（EFL）、症状限制递增功率心肺运动试验和恒定功率心肺运动试验。运动试验过程中同步进行Borg呼吸困难评分和下肢疲劳程度评分（BS）。结果运动训练后，康复组患者峰运动功率（WRpeak）显著提高（P〈0．05）；常规肺通气功能、弥散功能、肺容积指标无显著改善；5分法EFL评分无显著改善（P〉0．05）；最大吸气压显著增加（P〈0．01）；运动训练后等时间点Borg呼吸困难评分和下肢疲劳程度评分较前显著下降（P〈0．01）；△MIP（r=0．535，P〈0．05）、△Borg（r=0．512，P〈0．05）、△BS（r=0．497，P〈0．05）分别与△WRpeak呈显著正相关关系。结论下肢踏车运动训练可能通过增加吸气肌肉力量，减轻COPD患者在运动过程中呼吸困难和下肢疲劳的主观感觉，改善运动耐力。Objective To explore the relationship between improved exercise endurance and inspiratory muscle strength, dyspnea and lower limb fatigue in chronic obstructive pulmonary disease （COPD） patients. Methods Twelve moderate-to-severe COPD patients were given lower limb exercise training for 12 weeks. Routine tests of pulmonary ventilation function, diffusion function, lung volume, maximal inspiratory pressure （MIP） , expiratory flow limitation （EFL） , cycle ergometer exercise capacity and constant work rate capacity were administered before and after the training program. Borg＇s scale （BS） was used to assess dyspnea and lower limb fatigue was measured during the exercise tests. Results After training, the average peak work rate （WRpeak） and average MIP both had increased significantly, but no significant change was observed in routine puhnonary ventilation function, diffusion function or lung volume. The 5-point EFL score showed no significant change, but Borg＇ s scale dyspnea scores and lower limb fatigue decreased significantly. The changes in WRpeak were positively correlated with the MIP changes, Borg scale scores and changes in Borg scores. All of these relationships were statistically significant. Conclusion The improved exercise endurance of moderate-to-severe COPD patients after lower limb exercise training is due to increased inspiratory muscle strength and decreases in the sensation of dyspnea and lower limb fatigue.

关 键 词：慢性阻塞性肺病 肺康复 运动训练 呼吸困难 

分 类 号：R563.9[医药卫生—呼吸系统]